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EPA Attack On Asthmatics Coming To An End?

CEI warned policy makers a couple decades ago that an Environmental Protection Agency (EPA) phase out of over-the-counter sales of CFC containing asthma inhalers would threaten public health without providing environmental benefits. These products had been safely used for nearly 50 years, but EPA decided that the public should have limited access because of overblown concerns about their potential to harm the ozone layer. Because of that ban, asthmatics can only access asthma inhalers by prescription.

Congress is considering reversing -- albeit only temporarily -- this crazy policy thanks to a campaign launched by Amphastar, the makers of Primatene Mist CFC inhalers. Former Congressman Bart Stupak (D-Mich.) -- who now represents Amphastar -- makes some excellent points on the topic in The Hill's Congress Blog. The company has also launched a petition to bring back these inhalers.

According to Amphastar, it has an existing supply of 1 million units, which EPA could allow it to sell or dispose -- releasing the CFCs into the environment in both cases. It is likely that some asthmatics stocked up on these inhalers before their complete phase out at the end of 2011. But this supply has an expiration date of August 2013, meaning the company needs approval to make more units if asthmatics are to benefit from them after their existing supplies expire.

The House Energy and Commerce Committee held hearings on July 18 to discuss the Asthma Inhalers Relief Act of 2012 (H.R. 6190), which would allow sale of the existing supply until August 2013. If this legislation passes, consumers will have access for another year, during which Congress could consider a complete repeal of the ban to allow production and sale of these products after August 2013. The Independent Women's  Forum addressed the hearing on its blog, which you can check out here.

At the hearing, Dr. Edward Kerwin, an Allergy Asthma and Clinical Research Physician, who specializes in the treatment of Asthma and COPD [Chronic obstructive pulmonary disease] patients, testified on why consumers should have access to inhalers:

Asthma, COPD and Acute Bronchitis can occur in the middle of the night, on weekends, during hikes, picnics, excursions, or camps far from cities. Severe Asthma flare-ups and COPD/Bronchitis flare-ups can cause critical, sometimes progressive shortness of breath that can lead to death and very severe distress if untreated. Asthma especially is allergy and exercise triggered. Picnicking near a hay field, visiting relatives with cats, cleaning a moldy basement or dusty carpet can trigger severe life-threatening asthma flare-ups. Exercise also triggers flares. These generally require immediate treatment, usually with 2-4 puffs of a rescue bronchodilator given within minutes of the onset of airway obstruction. Death from asthma can occur within as little as 20 minutes (due to hypoxia, or starving for air) if asthma and bronchospasm are not rapidly treated. ... Since Acute Asthma, Acute COPD and Acute Bronchitis are potential medical emergencies requiring immediate treatment, over-the-counter therapies can play a key life-saving role when patients have a flare-up.

Some witnesses argued in favor of the ban because they don't think consumers are wise enough to use these inhalers judiciously. But the ban was never designed to serve such ill-founded nanny-statist goals. It stems from the U.S. implementation of the the Montreal Protocol on Substances that Deplete the Ozone Layer. The only question for regulators here is whether these inhalers have enough, if any, impact on the depletion of the ozone layer to justify denying consumers access to the life-saving devices. There are plenty reasons to doubt CFC Inhalers have any impact on the ozone layer, as noted in a very interesting piece published in the Tucson Citizen last fall.

The weak case for a ban was apparent at the time EPA imposed the ban. CEI policy analyst Ben Lieberman pointed out:

EPA justifies the [then] proposed ban on the grounds that it will help in "preventing dangerous pollution and protecting the environment." However, it is not clear whether the old CFC inhalers are bad for the environment, or that the new ones are benign. The amount of CFCs used in MDIs is too small to have an appreciable effect on the ozone layer, according to atmospheric scientists. Current data indicate that the annual CFC contribution from inhalers is approximately one three-thousandth of what is already in the atmosphere. Thus, an additional 5 years of CFC-inhaler use will add only 0.1 to 0.2 percent to the atmospheric burden of this gas. In addition, EPA has neglected to point out that its favorite new inhaler uses a compound called HFC-134a, which it has implicated as a greenhouse gas. Indeed, EPA is already in the process of banning HFC-134a in other uses, because of its "potential to contribute to global warming." Thus, if the ban on CFC-inhalers succeeds, their replacements could become the next regulatory target, leaving asthmatics with still fewer treatment options.